We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Serum fetuin-A in nondialyzed patients with diabetic nephropathy: Relationship with coronary artery calcification.
- Authors
Mehrotra, Rajnish; Westenfeld, Ralf; Christenson, Peter; Budoff, Matthew; Ipp, Eli; Takasu, Junichiro; Gupta, Ajay; Norris, Keith; Ketteler, Markus; Adler, Sharon
- Abstract
Serum fetuin-A in nondialyzed patients with diabetic nephropathy: Relationship with coronary artery calcification.Background.Fetuin-A is the most potent circulating inhibitor of calcium phosphorus precipitation and, possibly, an important mediator of insulin resistance.Methods.In order to determine the role of fetuin-A in the high coronary artery calcification (CAC) burden seen in nondialyzed individuals with diabetic nephropathy (DN), post-hoc analyses of data collected from a cross-sectional study of 88 patients with type 2 diabetes mellitus was done[age, 40–65 years; normoalbuminuria,N= 30 (Latinos); DN,N= 58 (Latinos and African Americans)].Results.The serum levels of fetuin-A were significantly higher among Latinos with DN when compared to either African Americans with DN or Latino diabetics with normoalbuminuria. Upon adjusting the data for race/ethnicity, there was a strong, direct relationship between serum fetuin-A levels and the CAC score (r= 0.22,P= 0.038) in the study cohort; however, a strong interaction between the nephropathy status and relationship of serum fetuin-A levels with CAC score was present (DN:r= 0.36,P= 0.006; diabetic controls,r= 0.0,P= 0.98). Among individuals with DN, the significance of the association persisted even after controlling the data for other predictors of CAC (partialr= 0.33,P= 0.018). Furthermore, there was a significant direct relationship between serum fetuin-A and serum triglycerides (partialr= 0.27,P= 0.01) and albumin (partialr= 0.30,P= 0.005), and an inverse relationship with glomerular filtration rate (r=−0.24,P= 0.03).Conclusion.This first study in early stages of diabetic chronic kidney disease shows that the role of serum fetuin-A may be far more complex than previously described. During predialysis stage of DN, there is a direct relationship between serum fetuin-A levels and CAC score. The reasons for this association in the presence of nephropathy are unclear, but may be secondary to proatherogenic insulin resistance.
- Subjects
SERUM; ALPHA fetoproteins; BLOOD proteins; DIABETIC nephropathies; CORONARY arteries; CALCIUM in the body; TYPE 2 diabetes
- Publication
Kidney International, 2005, Vol 67, Issue 3, p1070
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1111/j.1523-1755.2005.00172.x